Nosocomial and Community Acquired Infections in Korle Bu Teaching Hospital; Accra

BACKGROUND: Nosocomial or hospital acquired infection has been recognized as a serious public health problem in the last twenty years. In most hospitals in Africa-South of the Sahara; although the types of community acquired infections are known; neither the magnitude; nor the common types of nosocomial infections has been documented. OBJECTIVE: This study was carried out to find the prevalence of hospital and community acquired infections in hospitals; and to estimate the overall prevalence of HAI and CAI in Korle Bu Teaching Hospital. METHODS: A one-day prevalence survey of nosocomial and community acquired infection in a tertiary-care hospital in Accra was performed using the 1980 British national protocol and the result was analyzed using computerized gargets. RESULTS: Of the 907 patients on admission (on the day of the study); 61 (6.7) had hospital-acquired infection and 287 (31.6) had community acquired infection. The commonest hospital acquired infection was wound infection followed by skin and lower respiratory infections. Of the community infections; the most common cases were lower respiratory and skin infections. Fifty-three percent of all patients were on antimicrobial treatment. Patients on metronidazole were 212 (44); ampicillin/amoxicillin 199 (41.6); cloxacillin 163 (34) and gentamicin 135 (28). Approximately 20of patients were on three or more drugs. CONCLUSION: This study has shown that the prevalence of community acquired infections in our hospital is much higher than that from nosocomial infections and that the British national survey protocol can be used in countries with limited resources

Distribution of serogroups and serotypes of multiple drug resistant shigella isolates

Background: The distribution of Shigella sero-types is of epidemiological importance and antim-icrobial therapy for shigellosis can prevent poten-tial complications of shigellosis. Studies done fifty years ago in Ghana indicated the predominance of Shigella flexneri.Objectives: To describe the distribution of Shig-ella serogroups and serotypes and their anti-biogram profiles.Study design: A prospective descriptive study.Setting: The Microbiology Department of the Korle Bu Teaching Hospital.Methods: Consecutive stool specimens from pa-tients with diarrhoea submitted between February 2004 and June 2005 were cultured for Shigella and the isolates typed with commercial anti-sera. The susceptibilities of the isolates were also tested against eleven antimicrobial agents by the disc diffusion method. Minimum inhibitory concentra-tions (MIC) of isolates to ciprofloxacin were also determined by the E-test.Results: Five hundred and ninety four diarrhoea stool specimens yielded 24 Shigella isolates with the following serogroup distribution: S. flexneri 70.8

Antimicrobial resistance of urinary isolates in Accra

Of 5;059 unselected urine specimens cultured over a 5 month period in 1989; 1;030 (20.4 per cent) yielded significant growth. The predominant isolate was Escherichia coli (38.9 per cent); followed by Coliforms (18.5 per cent) and Klebsiella species (15.0 per cent). Over 75 per cent of these isolates were resistant to Ampicillin; Tetracycline and Cotrimozaxole. Less than 25 per cent were however resistant to Nalidixic Acid and Furandantin

Antimicrobial resistance of urinary isolates in Accra

Of 5;059 unselected urine specimens cultured over a 5 month period in 1989; 1;030 (20.4 per cent) yielded significant growth. The predominant isolate was Escherichia coli (38.9 per cent); followed by Coliforms (18.5 per cent) and Klebsiella species (15.0 per cent). Over 75 per cent of these isolates were resistant to Ampicillin; Tetracycline and Cotrimozaxole. Less than 25 per cent were however resistant to Nalidixic Acid and Furandantin